Service Location
The data in the MHDR is from Boston Medical Center and their affiliated community health centers. As there is a lot of movement between the medical facilities, developing strata that accurately identify the “core” patient population for each Service Location requires some limitations on how often patients may have visited each center in relation to the other centers.
The data below is from a Query focusing on Hypertension Control stratified by the following categories:
- Ever – Patient has Ever been seen at that location
- Only 2005+ – Patient has Only been seen at that location from 2005 to the present and NOT at any other CHC (Patients may have been seen at BMC)
- >=2, <=1 any other 2005+ – Patient has been seen at that CHC 2 or more times, and at any other CHC 1 or less times since 2005
As you can see Ever provides the most patients, however this might not be a good way to differentiate between patients who are seen at different locations.
| Strata | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 |
|---|---|---|---|---|---|---|---|
| ALL | 25,404 | 26,771 | 27,869 | 29,710 | 31,728 | 33,328 | 33,692 |
| BMC Ever | 24,336 | 25,713 | 26,717 | 28,550 | 30,540 | 32,056 | 32,399 |
| BMC ONLY 2005+ | 12,267 | 12,373 | 12,280 | 12,884 | 13,680 | 14,083 | 14,856 |
| BMC >=2, <=1 any CHC 2005+ | 12,822 | 13,012 | 12,933 | 13,599 | 14,412 | 14,867 | 15,701 |
| CHC 1 Ever | 2,641 | 2,922 | 3,075 | 3,250 | 3,404 | 3,515 | 3,513 |
| CHC 1 ONLY 2005+ | 2,354 | 2,589 | 2,718 | 2,871 | 3,003 | 3,099 | 3,102 |
| CHC 1 >=2, <=1 any other | 2,332 | 2,572 | 2,718 | 2,870 | 3,009 | 3,110 | 3,106 |
| CHC 2 Ever | 3,610 | 3,897 | 4,373 | 4,828 | 5,259 | 5,619 | 5,363 |
| CHC 2 ONLY 2005+ | 2,303 | 2,486 | 2,800 | 3,137 | 3,439 | 3,731 | 3,565 |
| CHC 2 >=2, <=1 any other 2005+ | 2,474 | 2,693 | 3,042 | 3,388 | 3,687 | 3,966 | 3,766 |
| CHC 3 Ever | 1,381 | 1,476 | 1,600 | 1,740 | 1,919 | 2,400 | 2,261 |
| CHC 3 >=2, <=1 any other 2005+ | 655 | 719 | 764 | 831 | 931 | 1,314 | 1,201 |
| CHC 3 Only 2005+ | 690 | 737 | 785 | 856 | 945 | 1,344 | 1,242 |
| CHC 4 Ever | 254 | 277 | 342 | 399 | 513 | 540 | 713 |
| CHC 4 Only 2005+ | 177 | 198 | 241 | 300 | 401 | 401 | 560 |
| CHC 4 >=2, <=1 any other 2005+ | 168 | 188 | 234 | 290 | 384 | 392 | 553 |
| CHC 5 Ever | 4,134 | 4,473 | 4,718 | 5,074 | 5,378 | 5,671 | 5,800 |
| CHC 5 Only 2005+ | 2,642 | 2,888 | 3,028 | 3,276 | 3,516 | 3,782 | 3,986 |
| CHC 5 >=2, <=1 any other 2005+ | 2,501 | 2,749 | 2,882 | 3,114 | 3,350 | 3,592 | 3,783 |
| CHC 6 Ever | 1,487 | 1,622 | 1,773 | 1,872 | 2,038 | 2,218 | 2,077 |
| CHC 6 ONLY 2005+ | 850 | 920 | 1,004 | 1,027 | 1,122 | 1,266 | 1,158 |
| CHC 6 >=2, <=1 any other 2005+ | 918 | 991 | 1,076 | 1,106 | 1,210 | 1,362 | 1,248 |
| CHC 7 Ever | 812 | 980 | 1,115 | 1,216 | 1,224 | 1,403 | 1,449 |
| CHC 7 ONLY 2005+ | 679 | 824 | 936 | 1,023 | 1,012 | 1,179 | 1,207 |
| CHC 7 >=2, <=1 any other 2005+ | 684 | 836 | 952 | 1,049 | 1,036 | 1,211 | 1,237 |
| CHC 8 Ever | 1,392 | 1,472 | 1,588 | 1,781 | 2,006 | 2,166 | 1,807 |
| CHC 8 ONLY 2005+ | 797 | 857 | 913 | 1,031 | 1,152 | 1,242 | 910 |
| CHC 8 >=2, <=1 any other 2005+ | 800 | 876 | 929 | 1,051 | 1,184 | 1,274 | 919 |
The table below presents the same data but as a Percentage (%) of the Ever category for each service location:
| Strata | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 |
|---|---|---|---|---|---|---|---|
| BMC ONLY 2005+ | 50.4 | 48.1 | 46.0 | 45.1 | 44.8 | 43.9 | 45.9 |
| BMC >=2, <=1 any CHC 2005+ | 52.7 | 50.6 | 48.4 | 47.6 | 47.2 | 46.4 | 48.5 |
| CHC 1 ONLY 2005+ | 89.1 | 88.6 | 88.4 | 88.3 | 88.2 | 88.2 | 88.3 |
| CHC 1 >=2, <=1 any other | 88.3 | 88.0 | 88.4 | 88.3 | 88.4 | 88.5 | 88.4 |
| CHC 2 ONLY 2005+ | 63.8 | 63.8 | 64.0 | 65.0 | 65.4 | 66.4 | 66.5 |
| CHC 2 >=2, <=1 any other 2005+ | 68.5 | 69.1 | 69.6 | 70.2 | 70.1 | 70.6 | 70.2 |
| CHC 3 Only 2005+ | 47.4 | 48.7 | 47.8 | 47.8 | 48.5 | 54.8 | 53.1 |
| CHC 3 >=2, <=1 any other 2005+ | 50.0 | 49.9 | 49.1 | 49.2 | 49.2 | 56.0 | 54.9 |
| CHC 4 Only 2005+ | 69.7 | 71.5 | 70.5 | 75.2 | 78.2 | 74.3 | 78.5 |
| CHC 4 >=2, <=1 any other 2005+ | 66.1 | 67.9 | 68.4 | 72.7 | 74.9 | 72.6 | 77.6 |
| CHC 5 Only 2005+ | 63.9 | 64.6 | 64.2 | 64.6 | 65.4 | 66.7 | 68.7 |
| CHC 5 >=2, <=1 any other 2005+ | 60.5 | 61.5 | 61.1 | 61.4 | 62.3 | 63.3 | 65.2 |
| CHC 6 ONLY 2005+ | 57.2 | 56.7 | 56.6 | 54.9 | 55.1 | 57.1 | 55.8 |
| CHC 6 >=2, <=1 any other 2005+ | 61.7 | 61.1 | 60.7 | 59.1 | 59.4 | 61.4 | 60.1 |
| CHC 7 ONLY 2005+ | 83.6 | 84.1 | 83.9 | 84.1 | 82.7 | 84.0 | 83.3 |
| CHC 7 >=2, <=1 any other 2005+ | 84.2 | 85.3 | 85.4 | 86.3 | 84.6 | 86.3 | 85.4 |
| CHC 8 ONLY 2005+ | 57.3 | 58.2 | 57.5 | 57.9 | 57.4 | 57.3 | 50.4 |
| CHC 8 >=2, <=1 any other 2005+ | 57.5 | 59.5 | 58.5 | 59.0 | 59.0 | 58.8 | 50.9 |
As you can see, depending on which strata you use your overall sample size may be diminished. However, if you are trying to examine differences between service locations it may be more appropriate to create distinct cohorts of patients seen only at (or primarily at) one service location or another.
Note: Data presented from the MHDR will almost always have the names of the Community Health Centers masked. This is because many factors affect healthcare outcomes (including demographic characteristics of both the patient population and the geographic location) therefore we discourage against drawing any conclusions about care quality based on direct comparisons. These strata are intended to demonstrate outcomes that may be affected by Service Location and inform future directions for research.
